Neuroscientist named in gunman's letter reflects on CTE after decades of studying brain injuries

New York Times

3 days ago

Chris Nowinski paused frequently.
On Monday, 27-year-old Shane Tamura walked into a Manhattan high-rise that houses NFL headquarters and killed four people with an assault rifle. The next day, reports surfaced that Nowinski's name was in a letter found on Tamura, who claimed he was suffering from the degenerative brain disease chronic traumatic encephalopathy (CTE).
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New York Mayor Eric Adams said authorities 'have reason to believe (Tamura) was focused' on the NFL.
Nowinski, who retired from World Wrestling Entertainment more than 20 years ago due to brain injuries, became a neuroscientist and eventually one of the world's most renowned figures in concussion and CTE research. Not long after, Nowinski's friend and WWE peer Chris Benoit killed his wife, son and then himself. Studies done by Nowinski's foundation after Benoit's death found significant brain damage that suggested the wrestler suffered from depression and CTE.
CTE, which is most commonly found in athletes, particularly those who participate in contact sports such as wrestling or football, can only be definitively diagnosed after a person has died. However, Nowinski and his Concussion Legacy Foundation think they are close to being able to diagnose individuals while they are still alive.
On Wednesday, a reflective Nowinski shared his thoughts with The Athletic about Monday's shooting, the stigmas surrounding brain injuries and what might happen with Tamura's brain.
(Questions and answers have been edited for clarity and length.)
What were your emotions upon hearing that your name was mentioned in the gunman's letter?
Um … I'm still processing.
Did Monday's news, and the news of your name being in the letter, make you reflect on the cases of Benoit and other previous tragedies?
Yes, when I learned about the shooting and the CTE claim, I did think about Chris Benoit, Phillip Adams, Aaron Hernandez and other cases that people aren't aware of that involved homicide and often suicide.
This is something we've seen before in people who have had CTE, but it's also been seen in a lot of people who don't.
When it comes to violent crimes like these, how do you balance the impact of brain trauma with the impact of mental health illnesses? Where does one end and the other begin?
No one would argue, in general, that having traumatic brain injuries can increase the odds of developing mental health disorders or increase the odds of abnormal behaviors. The question of the role of CTE as a brain disease, within that, especially in younger people, has a lot more unknowns than knowns.
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I try to focus on what we can potentially learn from these situations so we can prevent the next tragedy.
What are the dangers of CTE for younger athletes? Do concussions have a greater effect on young people?
When the brain is still developing, suffering traumatic brain injuries or repetitive head impacts can change what that brain was supposed to become. There's no question around that.
The nature of traumatic brain injuries is that they aren't the same in everybody. They injure specific parts of the brain, so we should never be surprised that people have different symptoms after brain injuries; it all depends on how your brain is wired and where the injuries occurred.
Most people who suffered traumatic injuries, in the big picture, are fine and recover completely or almost completely. For other people, one brain injury changes who they are for the rest of their lives.
Everybody who has CTE has gone through the process of getting repetitive traumatic brain injuries. So, in young people, is CTE simply because those repetitive traumatic brain injuries happened? Or is CTE also causing additional degeneration that is adding on top of the damage from the repetitive traumatic brain injuries?
Do you fear stigma becoming attached to people who have experienced traumatic brain injuries and might be, in the eyes of the public, more likely to have CTE or become violent?
We do have to be aware of the potential for stigma. On the other hand, we also have to be aware that the stories that we're hearing are only the tip of the iceberg.
The problem for someone like me is that families confide in us the truth about what their loved one went through. Many of the stories they tell us so that we can learn about them as scientists, but they are never willing to tell them publicly because a lot of those loved ones are high-profile members of the community.
We don't want everyone to think every ex-football player, including me, has the potential to do a terrible thing or is inevitably going to do a terrible thing. But we also have to balance that with the terrible things that are happening to these families.
In your past 19 years of studying concussions, how far do you feel we've come in our understanding of CTE and how much further do you think we need to grow as a society?
I think the most important advancement that has been made is finding that CTE is caused by repeated traumatic brain injuries, that there's not some mysterious other factor here.
But also, it's not just the symptomatic concussions that are causing it; the risk of CTE is most associated with the number and strength of repetitive hits taken over a lifetime, which gives us a path forward to preventing CTE.
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The problem we have is that almost no one is trying to prevent CTE, so we're still creating the same problem. There's very little acceptance that it is preventable, and the organizations that are creating CTE don't necessarily want to balance their role in creating CTE.
I hope that we're soon able to marshal the attention and resources this disease deserves so that we can actually diagnose and help people while they're alive, and also strengthen the case for why we should stop hitting kids in the head and we should really try to prevent this, because brain diseases are terrible.
If we knew how to prevent Alzheimer's disease, we would be doing everything. Yet for CTE, it has one cause, and we're almost doing nothing to prevent it.
Are we anywhere close to getting CTE testing available for athletes while they are alive?
We are, we are. The studies are finally happening that will tell us how to diagnose CTE in living people. … I do think it's just around the corner now.
Would you say it's a safe assumption to say that there is a startling number of active NFL, college or even high school football players who have early stages of CTE?
Yes. When the numbers are revealed, I think they will shock people.
As we look forward, can you walk us through what could happen now with Shane Tamura's brain?
Just speculating, because I don't have any inside information, but the New York City Medical Examiner's Office is among the most sophisticated in the world, and they have affiliated experts who understand CTE.
The brain will be fixed in formalin solution to harden, so it can then be processed and studied, and that will happen for two or three weeks. Then it'll be photographed and observed, as it is, and then it will begin to be cut in ways to study more than 20 different regions of the brain, looking for any and all abnormalities, both visible and those that need to be studied, which don't become visible until you use use a small brush with antibodies on the tissue which make abnormalities visible and be studied under a microscope.
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(The timeline) all depends on capacity. What you learn is that for all neuropathologists, there are more brains to be studied than there is time. If this was the only job they had, it could be done in under two months, but we'll see what the capacity is.
In 2007, when Benoit died, your advocacy was just beginning, and now, 18 years later, your name shows up again, almost like a symbol that is attached to the topic of CTE.
I've always felt guilt that I didn't go far enough to help Chris Benoit. Because I remember he asked me to call him, and I did call him, and he did answer, but he sounded agitated and said he'd call me back. Then he didn't, and I didn't chase him down.
Whether it's Benoit or Andre Waters, many of those early cases shaped my view that people can really suffer with this, and it really impacts their families. So my goal has always been to let people know that this is possible and drive those who are struggling to find help.
At the Concussion Legacy Foundation, we now have five full-time people just taking inbound helpline requests and ensuring people are connected with the best doctor for their symptoms.
I've dedicated my life to trying to make sure that those people can live their best life while trying to mobilize the world to find better answers, because their answers aren't good enough right now. And that means diagnosing and potentially curing this.
So with that, there's a lot of work to be done. In some aspects, we've made a lot of progress. But there's still so far to go, and I've got to figure out a way to get there faster.
(Top photo of Nowinski, far left, testifying before Congress in 2014: Win McNamee / Getty Images)